高原地区慢性肺源性心脏病患者不同病期血液和痰中细胞因子变化与肺功能的关系  

Correlation between the changes of cytokine in blood and sputum and the pulmonary function in patients with chronic cor pulmonale at different stage of disease at high altitude

作　　者：杨生岳[1] 冯恩志[1] 沈君礼[1] 赵丽红[1] 吴雪梅[1] 张瑛解 

机构地区：[1]放军第四医院兰州军区呼吸内科中心,青海省西宁市810014

出　　处：《中国临床康复》2005年第19期52-54,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:探讨高原地区慢性肺源性心脏病(肺心病)患者急性期、缓解期血液和痰中白细胞介素8(白介素8)和肿瘤坏死因子α的变化与肺功能的关系。方法:选择2002-01/2004-06解放军第四医院兰州军区呼吸内科中心住院的慢性肺心病患者50例(急性期),男32例,女18例,年龄55～76岁。纳入患者均确诊为急性加重期肺心病,均居住在海拔2260～3300m地区,并同意参加实验。另选2003-03/05同海拔本院健康查体自愿者20人作对照组,男13人,女7人,年龄54～74岁。入院当天检测血液中性粒细胞百分比;采取静脉血4mL制备血清,收集痰液,用酶联免疫吸附反应法检测痰上清液和外周血浆白介素8和肿瘤坏死因子α水平。然后给予常规综合治疗,其中住院期间死亡4例,其余46例病情缓解后3周重复上述检查。50例慢性肺心病患者在急性期和治疗3周病情缓解后(46例)作血常规及第1秒用力呼气量占预计值百分比测定。结果:最终进入结果分析急性期和缓解期肺心病患者分别为50和46例,健康人20人。①急性期患者外周血浆白介素8和肿瘤坏死因子水平明显高于缓解期犤(286.55±52.14),(45.67±7.34)ng/L,(133.39±35.13),(31.58±5.23)ng/L,t=10.53,8.97,P<0.01犦;而第1秒用力呼气量占预测值百分比明显低于缓解期犤(35.98±6.22)%,(44.66±5.34)%,t=5.43,P<0.01犦。急性期和缓解期患者外周血浆白介素8和肿瘤坏死因子水平明显高于对照组(t=9.12～25.14,P<0.01),第1秒用力呼气量占预测值的百分比明显低于对照组(t=29.08,18.76,P<0.01)。②急性期患者痰液中白介素8和肿瘤坏死因子水平犤(40.52±7.36),(19.42±3.25)ng/L犦明显高于缓解期犤(16.42±2.16),(9.30±2.64)ng/L,t=19.06,14.53,P<0.01犦。③血液中白介素8与第1秒用力呼气量占预测值的百分比呈显著负相关(r=-0.633,P<0.01);痰液中白介素8、肿瘤坏死因子与第1秒用力呼气量占预测值百分比呈显著负相关(r=-0.588,-0.607,-0.531AIM:To investigate the relationship of the changes of interleukin-8 and tumor necrosis factor alpha in blood and sputum with the pulmonary function in patients with chronic cor pulmonale at exacerbation and remission at high altitude.METHODS:Fifty patients with chronic cor pulmonale(at acute exacerbation)(32 males and 18 females) at 55 to 76 years of age,who were hospitalized in the Center of Respiratory Medicine,the 4 Hospital of Lanzhou Military Area Command of Chinese PLA between January 2002 and June 2004,were all diagnosed to have chronic cor pulmonale at acute exacerbation.All the patients lived in the area at the height of 2 260 to 3 300 m above sea level and agreed to participate in the study.Another 20 healthy physical examinees(13 males and 7 females) aged 54 to 74 years,who lived at the same height,in this hospital from March to May 2003 were taken as controls voluntarily(control group).The percentage of neutrophils in blood was detected on the day of hospitalization;Venous blood(4 mL) was drawn for preparation of serum,and sputum was collected,the levels of interleukin 8 and tumor necrosis factor alpha in sputum and peripheral blood were determined with enzyme linked immunosorbent assay(ELISA).Routine comprehensive treatment was given,4 cases died during hospitalization,the other 46 cases were reexamined 3 weeks after remission.Patients with chronic cor pulmonale received blood routine test and determination of percentage of forced expiratory volume in the first second to the predicted value.RESULTS:Finally,50 patients with chronic cor pulmonale at acute exacerbation and 46 at remission,and 20 healthy subjects were involved in the analysis of results.① The levels of interleukin 8 and tumor necrosis factor alpha in peripheral blood were obviously higher in patients at acute exacerbation[(286.55± 52.14),(45.67± 7.34) ng/L] than in those at remission[(133.39± 35.13),(31.58± 5.23) ng/L](t=10.53,8.97,P< 0.01),the percentage of forced expiratory volume in the first second to the predicted value was ma

关 键 词：肺疾病 慢性阻塞性 白细胞介素8/分析 肿瘤坏死因子/分析 

分 类 号：R54[医药卫生—心血管疾病]